Usefulness of whole-blood interferon-γ assay and interferon-γ enzyme-linked immunospot assay in the diagnosis of active pulmonary tuberculosis

youngae kang, Hye Won Lee, Seung Sik Hwang, Sang Won Um, Sung Koo Han, Young Soo Shim, Jae Joon Yim

Research output: Contribution to journalArticle

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Abstract

Purpose: The aim of this study was to evaluate the usefulness of the whole-blood interferon-γassay (enzyme-linked immunosorbent assay [ELISA]) and interferon-γ enzyme-linked immunospot assay (ELISPOT) based on early secretory antigenic target 6 and culture filtrate protein 10 in the diagnosis of active pulmonary tuberculosis (TB) in routine clinical practice. Method: We conducted a prospective study enrolling 144 participants with suspected pulmonary TB in a tertiary referral hospital in Seoul, South Korea, to investigate the diagnostic sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of these tests. Clinical assessment, tuberculin skin test (TST), whole-blood interferon-γ ELISA (Quanti-FERON-TB Gold [QFT-G]; Cellestis Ltd; Victoria, Australia), and an ELISPOT assay (T SPOT.TB; Oxford Immunotec; Oxford, UK) were performed. Test results were compared with the final confirmed diagnoses. Results: Active pulmonary TB was diagnosed in 67 of 144 participants (47%). Sensitivities of QFT-G and T SPOT.TB for active pulmonary TB were 89% (95% confidence interval [CI], 79 to 96%) and 92% (95% CI, 83 to 97%), respectively; and specificities were 49% (95% CI, 37 to 61%) and 47% (95% CI, 36 to 59%). NPVs of QFT-G (84%; 95% CI, 69 to 93%) and T SPOT.TB (87%; 95% CI, 73 to 96%) were higher than that of TST (64%; 95% CI, 51 to 76%) [p = 0.001 and p < 0.001, respectively]. Conclusion: High NPVs of QFT-G and T SPOT.TB for the diagnosis of active TB suggest the supplementary role of these tests for the diagnostic exclusion of active TB, although the low PPV limits their usefulness in routine clinical practice in South Korea, where the prevalence of latent TB infection is considerable.

Original languageEnglish
Pages (from-to)959-965
Number of pages7
JournalChest
Volume132
Issue number3
DOIs
Publication statusPublished - 2007 Jan 1

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Enzyme-Linked Immunospot Assay
Pulmonary Tuberculosis
Interferons
Tuberculosis
Confidence Intervals
Gold
Republic of Korea
Tuberculin Test
Skin Tests
Enzyme-Linked Immunosorbent Assay
Predictive Value of Tests
Latent Tuberculosis
Victoria
Routine Diagnostic Tests
Tertiary Care Centers
Prospective Studies
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

kang, youngae ; Lee, Hye Won ; Hwang, Seung Sik ; Um, Sang Won ; Han, Sung Koo ; Shim, Young Soo ; Yim, Jae Joon. / Usefulness of whole-blood interferon-γ assay and interferon-γ enzyme-linked immunospot assay in the diagnosis of active pulmonary tuberculosis. In: Chest. 2007 ; Vol. 132, No. 3. pp. 959-965.
@article{c87a7483cd91416a8268f9e2d13ce46d,
title = "Usefulness of whole-blood interferon-γ assay and interferon-γ enzyme-linked immunospot assay in the diagnosis of active pulmonary tuberculosis",
abstract = "Purpose: The aim of this study was to evaluate the usefulness of the whole-blood interferon-γassay (enzyme-linked immunosorbent assay [ELISA]) and interferon-γ enzyme-linked immunospot assay (ELISPOT) based on early secretory antigenic target 6 and culture filtrate protein 10 in the diagnosis of active pulmonary tuberculosis (TB) in routine clinical practice. Method: We conducted a prospective study enrolling 144 participants with suspected pulmonary TB in a tertiary referral hospital in Seoul, South Korea, to investigate the diagnostic sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of these tests. Clinical assessment, tuberculin skin test (TST), whole-blood interferon-γ ELISA (Quanti-FERON-TB Gold [QFT-G]; Cellestis Ltd; Victoria, Australia), and an ELISPOT assay (T SPOT.TB; Oxford Immunotec; Oxford, UK) were performed. Test results were compared with the final confirmed diagnoses. Results: Active pulmonary TB was diagnosed in 67 of 144 participants (47{\%}). Sensitivities of QFT-G and T SPOT.TB for active pulmonary TB were 89{\%} (95{\%} confidence interval [CI], 79 to 96{\%}) and 92{\%} (95{\%} CI, 83 to 97{\%}), respectively; and specificities were 49{\%} (95{\%} CI, 37 to 61{\%}) and 47{\%} (95{\%} CI, 36 to 59{\%}). NPVs of QFT-G (84{\%}; 95{\%} CI, 69 to 93{\%}) and T SPOT.TB (87{\%}; 95{\%} CI, 73 to 96{\%}) were higher than that of TST (64{\%}; 95{\%} CI, 51 to 76{\%}) [p = 0.001 and p < 0.001, respectively]. Conclusion: High NPVs of QFT-G and T SPOT.TB for the diagnosis of active TB suggest the supplementary role of these tests for the diagnostic exclusion of active TB, although the low PPV limits their usefulness in routine clinical practice in South Korea, where the prevalence of latent TB infection is considerable.",
author = "youngae kang and Lee, {Hye Won} and Hwang, {Seung Sik} and Um, {Sang Won} and Han, {Sung Koo} and Shim, {Young Soo} and Yim, {Jae Joon}",
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Usefulness of whole-blood interferon-γ assay and interferon-γ enzyme-linked immunospot assay in the diagnosis of active pulmonary tuberculosis. / kang, youngae; Lee, Hye Won; Hwang, Seung Sik; Um, Sang Won; Han, Sung Koo; Shim, Young Soo; Yim, Jae Joon.

In: Chest, Vol. 132, No. 3, 01.01.2007, p. 959-965.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Usefulness of whole-blood interferon-γ assay and interferon-γ enzyme-linked immunospot assay in the diagnosis of active pulmonary tuberculosis

AU - kang, youngae

AU - Lee, Hye Won

AU - Hwang, Seung Sik

AU - Um, Sang Won

AU - Han, Sung Koo

AU - Shim, Young Soo

AU - Yim, Jae Joon

PY - 2007/1/1

Y1 - 2007/1/1

N2 - Purpose: The aim of this study was to evaluate the usefulness of the whole-blood interferon-γassay (enzyme-linked immunosorbent assay [ELISA]) and interferon-γ enzyme-linked immunospot assay (ELISPOT) based on early secretory antigenic target 6 and culture filtrate protein 10 in the diagnosis of active pulmonary tuberculosis (TB) in routine clinical practice. Method: We conducted a prospective study enrolling 144 participants with suspected pulmonary TB in a tertiary referral hospital in Seoul, South Korea, to investigate the diagnostic sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of these tests. Clinical assessment, tuberculin skin test (TST), whole-blood interferon-γ ELISA (Quanti-FERON-TB Gold [QFT-G]; Cellestis Ltd; Victoria, Australia), and an ELISPOT assay (T SPOT.TB; Oxford Immunotec; Oxford, UK) were performed. Test results were compared with the final confirmed diagnoses. Results: Active pulmonary TB was diagnosed in 67 of 144 participants (47%). Sensitivities of QFT-G and T SPOT.TB for active pulmonary TB were 89% (95% confidence interval [CI], 79 to 96%) and 92% (95% CI, 83 to 97%), respectively; and specificities were 49% (95% CI, 37 to 61%) and 47% (95% CI, 36 to 59%). NPVs of QFT-G (84%; 95% CI, 69 to 93%) and T SPOT.TB (87%; 95% CI, 73 to 96%) were higher than that of TST (64%; 95% CI, 51 to 76%) [p = 0.001 and p < 0.001, respectively]. Conclusion: High NPVs of QFT-G and T SPOT.TB for the diagnosis of active TB suggest the supplementary role of these tests for the diagnostic exclusion of active TB, although the low PPV limits their usefulness in routine clinical practice in South Korea, where the prevalence of latent TB infection is considerable.

AB - Purpose: The aim of this study was to evaluate the usefulness of the whole-blood interferon-γassay (enzyme-linked immunosorbent assay [ELISA]) and interferon-γ enzyme-linked immunospot assay (ELISPOT) based on early secretory antigenic target 6 and culture filtrate protein 10 in the diagnosis of active pulmonary tuberculosis (TB) in routine clinical practice. Method: We conducted a prospective study enrolling 144 participants with suspected pulmonary TB in a tertiary referral hospital in Seoul, South Korea, to investigate the diagnostic sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of these tests. Clinical assessment, tuberculin skin test (TST), whole-blood interferon-γ ELISA (Quanti-FERON-TB Gold [QFT-G]; Cellestis Ltd; Victoria, Australia), and an ELISPOT assay (T SPOT.TB; Oxford Immunotec; Oxford, UK) were performed. Test results were compared with the final confirmed diagnoses. Results: Active pulmonary TB was diagnosed in 67 of 144 participants (47%). Sensitivities of QFT-G and T SPOT.TB for active pulmonary TB were 89% (95% confidence interval [CI], 79 to 96%) and 92% (95% CI, 83 to 97%), respectively; and specificities were 49% (95% CI, 37 to 61%) and 47% (95% CI, 36 to 59%). NPVs of QFT-G (84%; 95% CI, 69 to 93%) and T SPOT.TB (87%; 95% CI, 73 to 96%) were higher than that of TST (64%; 95% CI, 51 to 76%) [p = 0.001 and p < 0.001, respectively]. Conclusion: High NPVs of QFT-G and T SPOT.TB for the diagnosis of active TB suggest the supplementary role of these tests for the diagnostic exclusion of active TB, although the low PPV limits their usefulness in routine clinical practice in South Korea, where the prevalence of latent TB infection is considerable.

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